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The treatment of breast ptosis using mastopexy associated with the inclusion of a silicone prosthesis in a single surgical procedure is a challenge for surgeons. The aim of this study is to describe the 15-year experience with the placement of silicone breast implants in double, subfascial and submuscular space, in the treatment of patients with breast ptosis, and to analyze the aesthetic results of patients who underwent such surgeries. During the 15-year period, between 2005 and 2020, 640 mastopexies were performed with the inclusion of silicone breast implants in double space, with high-profile round polyurethane prostheses whose volumes ranged from 135 to 435 ml, in patients with grade 2 and 3 breast ptosis. The age of the patients ranged from 18 to 55 years and the average age was 34 years. The postoperative follow-up time was 18 months. 400 patients (62.5%) had grade II ptosis, whereas 240 of them (37.5%) had grade III ptosis. The main complications were: 19 cases (3%) of residual sagging skin, 19 cases (3%) of unsightly scars, 12 cases (2%) of partial areola necrosis. There was no case of infection or seroma. There were 330 primary surgeries (52%) and 310 secondary surgeries (48%). After 15 years of performing mastopexy with prosthesis in double space, both in primary and secondary surgeries, it can be concluded that the technique reached its maturity providing good long-term results with the maintenance of the projection of the upper pole of the breast and low recurrence of ptosis in the lower pole and low rate of complications. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266

The treatment of breast ptosis using mastopexy associated with the inclusion of a silicone prosthesis in a single surgical procedure is a challenge for surgeons. The aim of this study is to describe the 15-year experience with the placement of silicone breast implants in double, subfascial and submuscular space, in the treatment of patients with breast ptosis, and to analyze the aesthetic results of patients who underwent such surgeries.During the 15-year period, between 2005 and 2020, 640 mastopexies were performed with the inclusion of silicone breast implants in double space, with high-profile round polyurethane prostheses whose volumes ranged from 135 to 435 ml, in patients with grade 2 and 3 breast ptosis.The age of the patients ranged from 18 to 55 years and the average age was 34 years. The postoperative follow-up time was 18 months. 400 patients (62.5%) had grade II ptosis, whereas 240 of them (37.5%) had grade III ptosis. The main complications were: 19 cases (3%) of residual sagging skin, 19 cases (3%) of unsightly scars, 12 cases (2%) of partial areola necrosis. There was no case of infection or seroma. There were 330 primary surgeries (52%) and 310 secondary surgeries (48%).After 15 years of performing mastopexy with prosthesis in double space, both in primary and secondary surgeries, it can be concluded that the technique reached its maturity providing good long-term results with the maintenance of the projection of the upper pole of the breast and low recurrence of ptosis in the lower pole and low rate of complications.This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Surgery for abdominal wall has showed significant progress in recent decades, related to reduce the area for undermining, as well as on the size of the final scars. We have observed cases of minor localized adiposities with reduced muscular diastases but with significant changes of the umbilicus which there is no indication for liposuction, traditional abdominoplasty, or lipoabdominoplasty.

Abdominoplasty surgery has spread universally, as both an aesthetic and a reconstructive procedure, and new techniques are appearing with the goal of minimizing ischemic complications of the flap and bettering body contour. The purpose of this article is to demonstrate that an abdominoplasty technique with limited undermining and preservation of the flap perforator vessels makes it possible to reduce the complication rate attributable to flap necrosis and seroma in abdominoplasty. Doppler flowmetry color study of the abdominal wall was performed before the surgical procedure and on postoperative day 15 after lipoabdominoplasty for a series of 20 patients to evaluate the blood supply of the abdominal wall. This study confirmed the preservation of perforator arteries in the periumbilicus area and right upper quadrant after abdominoplasty with liposuction and reduced undermining.

According to the authors, advantages of short scar face lift associated with lateral SMASectomy and vertical vector closure include a lower rate of hematomas and facial nerve injury, less skin tailoring, no retroauricular skin slough, and reduced operative time. Results in 96 patients demonstrate good neck redefinition, excellent facial contour, and elevated midface. (Aesthetic Surg J 2003;23:198-201.)

Abdominal compartment syndrome is directly related to an increase in intraabdominal pressure (IAP), which can lead in severe cases to serious clinical consequences. Routine measurement of IAP in specific cases has been advocated by some surgical specialties. However, few studies in plastic surgery have focused on the use of IAP. The authors review the literature and describe a method of IAP analysis used for 12 patients who underwent abdominoplasty.

Healing is a highly complex process with different phases. Because some medicinal plants have antiinflammatory properties, they could influence the wound healing process. There are many species of medicinal plants used for research, among them the Orbignya phalerata (Babassu).To analyze, comparatively, the tensiometric and histologic alterations in the healing process of colon anastomosis with the use of aqueous extract of the babaçu mesocarp.Forty Wistar male rats were used, divided in two groups of 20 animals named control and experimental group. Each group was further divided in two sub-groups of 10 animals and evaluated on the third and seventh post-operative days. Colotomy and one suture line coloraphy was performed in all animals. The control group received an intraperitoneal single dose of isotonic saline solution at the time of the surgery. The animals from the experimental group received babassu aqueous extract dose with 50mg/kg/weight, concentration of 25 mg/ml dose, with the same administration method. The following parameters were evaluated: a) macroscopic appearance of abdominal wall and cavity; b) tensiometric evaluation of anastomosis (bursting pressure); c) histologic characteristics of anastomosis.The macroscopic examination showed the presence of adherences in all animals with statistical significance in the ones from the experimental group at third day when compared to the control group. No difference was observed in the seventh-day group. No fistulae, abscesses and/or hemorrhage were observed. In regard to the tensiometric variation, the bursting pressure for the control and experimental groups, both for the third day (25.4 mmHg - 14.8 mmHg) and at seventh (183 mmHg - 175 mmHg), were similar with no significant difference. Histological analysis for the third day showed significant difference in the experimental group in relation to the controls, in regard the presence ofto mononuclear ones whereas at seventh day there was significant statistical difference in all variables from the experimental group compared to the control one.A favorable effect with administration of the aqueous extract of the babaçu mesocarp was seen in histological parameters of the healing process of colon anastomosis however there was no difference in the tensiometric evaluation between the control and experimental group.